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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Scientific Journal of Pediatrics
Willy Yahya
Ophthalmology Residency Program, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Neglected Total Rhegmatogenous Retinal Detachment with Proliferative Vitreoretinopathy Coexisting with Bilateral Grade IV Hypertensive Retinopathy in Severe Pre-eclampsia: A Case Report from an Indonesian Archipelagic Province Willy Yahya; Daniel Johosua Siegers; Ari Andayani; I Wayan Ardy Paribrajaka
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i9.1657

Abstract

Background: Pre-eclampsia injures the eye through the same endothelial mechanism that injures the kidney and brain, and its retinal signs track systemic severity. Rhegmatogenous retinal detachment arises by an entirely different mechanism, yet where vitreoretinal care is distant the two may present together in one patient, a coexistence not previously described. Objective: To describe a previously unreported coexistence of chronic rhegmatogenous retinal detachment and grade IV hypertensive retinopathy of severe pre-eclampsia in one patient, and to set out the structural features that distinguish the two mechanisms at the bedside — the distinction that determines whether treatment is medical or surgical. Case presentation: A 36-year-old woman was examined three weeks after a term vaginal delivery, four months after sudden visual loss in the left eye that began in the fifth month of a pregnancy complicated by pre-eclampsia. She also reported 19 years of unassessed visual loss in the right eye. Blood pressure was 154/114 mmHg. Acuity was hand movement right and 0.1 decimal left. The right eye showed total retinal detachment with a break at 9 o'clock, fixed folds, pigment clumping, grade C posterior proliferative vitreoretinopathy, posterior subcapsular cataract and a 7-degree sensory exotropia; the left eye showed optic disc swelling, peripapillary haemorrhage and a macular star. Both eyes met Scheie grade IV. Left macular tomography gave a central subfield of 182 micrometres and a minimum foveal thickness of 98, with five of nine sectors below the first percentile. No relative afferent pupillary defect was detectable. Conclusion: Chronic rhegmatogenous and hypertensive retinal disease can coexist in one patient and must be separated structurally, because only one responds to blood pressure control. Sub-percentile macular thinning tempers the expectation of full recovery, and bilateral disease can abolish the relative afferent pupillary defect that would otherwise flag a blind eye.
ICROP Third-Edition Phenotypes of Retinopathy of Prematurity and Their Association with Gestational Age in Indonesian Preterm Infants: A Retrospective Study I Wayan Eka Sutyawan; I Wayan Ardy Paribrajaka; Ni Made Ayu Surasmiati; Willy Yahya
Scientific Journal of Pediatrics Vol. 4 No. 1 (2026): Scientific Journal of Pediatrics
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjped.v4i1.333

Abstract

Background: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness, and middle-income countries face a third epidemic as neonatal survival outpaces screening capacity. Indonesian data using the third ICROP edition are scarce. Objective: To describe the ICROP third-edition phenotype distribution among Indonesian infants with ROP and evaluate the associations of severity with gestational age and birth weight using exact inference and partial identification. Methods: This retrospective STROBE-compliant study characterised the ICROP phenotype of 39 infants with ROP at a tertiary referral hospital in Denpasar between January 2020 and December 2022, and examined severity against gestational age and birth weight. Proportions carry 95% Wilson intervals; the gestational-age-by-stage cross-classification was reconstructed under the published marginals, tested by exact methods, and bounded across every reconstruction. Results: Mean gestational age was 28.7 ± 2.7 weeks and mean birth weight was 1091 ± 320 g; 94.9% were of very low birth weight. Stage was documented for 38 infants: stage 1, 68.4%; stage 2, 28.9%; and stage 3, 2.6%. Pre-plus and plus disease each affected 7.7%, and aggressive ROP affected 2.6%. Stage ≥2 occurred in 70.0% of infants born before 28 weeks versus 17.9% of those born later (odds ratio 9.16, 95% CI 1.90–44.10; exact P = 0.005; Cramér’s V = 0.370), with a monotone trend across strata (exact P = 0.004). Across all 30 admissible reconstructions, the exact P ranged from 0.004 to 0.115 and the odds ratio from 0.03 to 9.16. Birth weight carried no usable information because 94.9% of the cohort occupied a single stratum. Conclusion: Gestational age, not birth weight, should anchor ROP surveillance intensity in Indonesian tertiary units, while a broad birth-weight entry threshold is retained.
Co-Authors Ari Andayani Daniel Johosua Siegers I Wayan Ardy Paribrajaka I Wayan Ardy Paribrajaka I Wayan Eka Sutyawan Ni Made Ayu Surasmiati